01-104104 City of Federal Way Electrical Permit #:01 - 104104 - 00 - EL
Community Development Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661 4129 Inspection request line: 253.835.3050
Project Name: HA NA TERIYAKI
Project Address: 106 SW CAMPUS Dr. SI-e...."5 Parcel Number: 415920 0710
Project Description: ELE-Adding 11 new circuits to existing service
Owner Applicant Contractor
KAREN KIM L&D ELECTRIC L&D ELECTRIC
1819 MEEKER ST 14811 16TH AVE CT S 14811 16TH AVE CT S
KENT WA 98032 SPANAWAY WA 98387 SPANAWAY WA 98387
(253)208-6582
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Electrical Fixtures
Description Quantity ', Description Quantity Description Quantity
Alt.Serv./Feeder up to 200 amps-Co 1
PERMIT EXPIRES April 22,2002,IF NO WORK IS STARTED.
Permit issued on October 24,2001
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: - Date:7( )C - E5 I
jG ZG p` IA/ i7
OTT Or CONSTRUCTION PERMIT APPLICATION
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t3EVE�.OPMENTDEPpB1 BU APPLICATION NUMBER: Di - Lag( Q - OD
APPLICATION NUMBER: -
oc• 24 2691 APPLICATION NUMBER: _ _ -
**The following is required information—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
�i PROPERTY INFORMATION
SITE ADDRESS: /0 S l l� if fpr.'S D� C 8) ASSESSOR'S TAX/PARCEL#:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• EAI PROJECT INFORMATION
TYPE OF PROJECT(This application): 0 B ILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION
X ELECTRICAL 0 ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description):
Aga) (//) C:YCa
�,PROJECT NAME: -eiv ,
11 PEOPLE INFORMATION
PROPERTY OWNER: NAME: p Y, 4.,,A (/,;4 DAYTIME PHONE: -
19
MAIUNG ADDRESS(STREETADDRESS;CITY,STATE,ZIP):
i �i •
CONTRACTOR: NAME: DAYTIME PHONE:
n e/er. k z (. ) "—e 0
MAILING ADDRESS(STRREE`EETI ADDRESS;OCIT-Y,STATE,ZIP): (E`VENING PHONE:
/at/CITEDERAL WAY '&i'BUSINESS 1E cc-
,01 ILA �2�� FAX NUM
( ) -
CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required)
APPLICANT: NAME: oaYfIM PHON'E`: i,
Cii/CAJC
DD
MAILING ADDRESS(STREEE!TRESS;CITY,STATE,ZIP): EVENIN PHONE:
qefll
(L{f :/JAve__ c ' /41,00-14),' �� ? � ( ). �- W
RELASHIP TO
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROTECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL _
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS.
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) LOG
(S)GAS REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
lk DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that th information furnished by me is true and correct to the best of my knowledge,and
further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
further agree to hold harmless the Cityof Federal Way as to any claim(induding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such daim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy
of the information supplied to .ty as a part of this application.
NAME/TITLE: DATE:/ �
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR
FOR OFFICE-USE ONLY: #
Q NEIN ADDITION ❑ ALTERATION ❑;REPAIR .-. . `C7-TENANT°IMPROVEMENT:
CENSUSCODE: .- Lai-SUE: .
•ZONING DESIGNATION BUILDING SHELL ONLY? r:❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? D,YES Q NO
SECTION TOWNSHIP . . RANGE' NEW ADDRESS REQUIRED? YES ❑:NO
PLATTED LOT?`- ❑YES. ❑ NO CHANGE OF.USE?. . ' . ❑ YES 1:1 NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH-PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129